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PCM III Exam 2 > Suture Techniques > Flashcards

Suture Techniques Flashcards

1
Q

platelets aggregate

A

at low velocity of blood

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2
Q

bleeding allows

A

slows velocity

-platelets can drift

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3
Q

first responders

A

pro-inflammatory cytokines

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4
Q

fresher the wound

A

the more successful the closure

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5
Q

graft of skin

A

to heal large SA wounds

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6
Q

three principles of wound repair

A

1 minimize trauma to tissue

  • sharp teeth instead of crushing instruments
  • skin hooks, forceps with teeth, sharp needles

3 accurately approximate wound edges and landmarks

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7
Q

three phases of wound healing

A

1 inflammatory
2 proliferative
3 remodeling

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8
Q

inflammatory phase

A

immediately and lasts 5 days

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9
Q

proliferative phase

A

starts within 24 hours seals wound from water

-for 6 months

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10
Q

remodeling phase

A

continues up to two years

-ex/ move the couch from here to here, my wife

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11
Q

when can shower with wound?

A

24 hours proliferative phase is sealed from from water

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12
Q

when to close?

A

fresh wounds

large clean woulds

over cartilage or bone

to reduce scarring

to reduce bleeding

surgically debrided and irrigated wounds

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13
Q

when not to close?

A

old wonds that are contaminated
-unless cosmetic**

abscess that are drained

wounds that have opened after previous repair - secondary intention

possible foreign body in wound

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14
Q

laceration closes

A

from the bottom up

pushes fluid and debris out

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15
Q

puncture wound closes

A

early closure of skin stops drainage and leads to abscess formation

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16
Q

anesthetics in abscess

A

dont work well due to generally acidic environment

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17
Q

lidocaine

A

blocks sodium channels of depolarization

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18
Q

what leads to scarring

A

tissue tension

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19
Q

deep fixation

A

needed to control scarring

deeper tissue layers

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20
Q

ABCD of wound closure

A

A-B - superficial

C-D - deep

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21
Q

sutures in muscles

A

always pull out

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22
Q

more sutures

A

greater chance of infection

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23
Q

langer lines

A

close wounds parallel to langer lines for best cosmetic results

provides least tension

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24
Q

mobility to sides of wound?

A

undercut or undermine

  • go out 2/3 width of wound
  • into subQ tissue

in cases where skin does not come together

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25
Q

simple interrupted suture

A

most common

down across up and tie

square

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26
Q

evert

A

pucker of wound

just want a little eversion

27
Q

for long wounds to close fast

A

continuous running suture

28
Q

continuous running suture

A

tension difficult

keep equally spaced

29
Q

running lock suture

A

to keep tension from changing too much in running suture

like an interrupted but you loop under last instead of tying off

30
Q

vertical mattress suture

A

double closure of wound
-shallow and deep stitch

-place vertical mattress suture at place of greatest tension

31
Q

pulley stitchv

A

like a lock with a vertical mattress

large gaping thigh and abdominal wounds in fluffy folks (fluffy people)

32
Q

horizontal mattress suture

A

good closure on fragile tissue

in between fingers
down on groin

33
Q

running subcuticular tissue

A

totally buried within skin

-this is hot new stuff

34
Q

to avoid puckering with running subQ?

A

enter skin on opposite side slightly behind where needle exited

35
Q

smallest scar formation

A

running subticular closure

36
Q

flap problems

A

apex turning toward heart

  • area without blood supply
  • only blood - retrograde
37
Q

flap stitches?

A

**not interrupted suture

put a horizontal suture to allow blood flow

38
Q

make sure an incision

A

is 3-4x as long as it is wide

39
Q

6mm mole?

A

at least 18-24mm long incision

40
Q

less length to width

A

you’ll get a dog ear on the end

lift it up - and cut the corner off

will take the length out to what it shouldve been

41
Q

clamp needle

A

between body and swage

-curve designed to capture correct bite of tissue with turn of wrist

42
Q

hold forceps

A

like a pencil

-not serving tongs**

43
Q

forceps without teeth

A

crush tissue

44
Q

double wrap

A

only first

45
Q

finer and sharper the needle

A

less traumatic

46
Q

reverse cutting

A

for finger nail

47
Q

spatula curved

A

for big wounds
-like abdomen

for retention sutures

48
Q

larger the number?

A

the smaller the size

49
Q

non-absorbable

A

nylon
ethilon ermalon
prolene
merseline

50
Q

absorbable

A

gut and chromic gut - days

vycryl, monocryl, polyglycolic acid sutures - weeks

silk, cotton - years

51
Q

gut suture

A

days

52
Q

man-made absorbable

A

with cryl

-weeks to dissolve

53
Q

silk cotton

A

years to absorb

54
Q

monofilament

A

needs 6 good knots to stay

good for leaving a long time

more aseptic

55
Q

braided suture

A

needs 3-4 knots to stay

-does have pockets for bacteria - increased infection rate

56
Q

butterflys

A

steristrips

57
Q

dermabond

A

will bond everything
-super glue

don’t glue your fingers to wound

58
Q

skin staples

A

for very long wounds

placed 4-5mm apart

skin edges approxmiated with toothed forceps

59
Q

face stitches

A

3-5 days

60
Q

scalp stitches

A

7 days

61
Q

chest and extremity stitches

A

8-10 days

62
Q

back stitches

A

10-14 days

63
Q

high tension areas

-joints or hands

A

10 - 14 days

PCM III Exam 2 (8 decks)

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